


Case Notes

by Katzedecimal



Series: Rat, Wedding, Bow [4]
Category: Sherlock (TV)
Genre: Fluff and Angst, Gen, PTSD, Psychology, Therapy
Language: English
Status: Completed
Published: 2013-01-31
Updated: 2013-01-31
Packaged: 2017-11-27 17:31:35
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 831
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/664593
Author URL: https://archiveofourown.org/users/Katzedecimal/pseuds/Katzedecimal
Summary: <blockquote class="userstuff">
              <p>The case notes of Dr. Jason Emmerson, Ph.D. Registered Psychologist, concerning new patient Sherlock Holmes.</p>
            </blockquote>





	Case Notes

**Author's Note:**

  * For [Bitenomnom](https://archiveofourown.org/users/Bitenomnom/gifts).



patient notes, Sherlock Holmes, London  
Jase Emmerson, Ph.D. Registered Psychologist

Sherlock Holmes is a 38 year old Caucasian British male, recently entered into civil partnership with his flatmate of four years, who is struggling with post-traumatic symptoms including flashbacks and nightmares. I saw Sherlock on November 3. Sherlock related a negative past history with therapists but agreed to see me in deference to his partner's observations, after Sherlock experienced a full-immersion flashback wherein he very nearly re-enacted the originating trauma. Sherlock was referred to me through some of my relatives, who are his friends.

Sherlock began session in a defencive posture of arms crossed across his chest and legs crossed at the ankles, and remained so while describing his experiences with various child psychiatrists throughout his youth. He changed to a protective posture, drawing his knees up to his chest, when relating his experiences with therapists in rehab, who returned a diagnosis of high-functioning sociopath (based on my observations and assessment, I do not agree with this diagnosis.). Sherlock has struggled with clinical depression, ostracism and social isolation for many years and has a history of self-medicating, primarily with cocaine and heroin. Sherlock's current issues stem from a series of traumatic events and being forcibly separated from the stabilising influence of his flatmate. 

Sherlock demonstrates alexythemia compounded by a restrictive upbringing, resulting in difficulty identifying his emotions which renders conventional therapeutic techniques useless. I explained my preference for playing to the highly visual nature of minds like his, and for categorising emotions as "big bad, little bad, little good, big good" rather than trying to name them. He immediately showed interest and his posture became more open. 

We discussed the state of 'just being' and how Sherlock finds that state of calm contentment. He revealed he is at his most content when working at home at his microscope, while his partner works on his laptop or watches telly. This is the situation where he most feels all is right with his world. He relates that he does not always need to talk to his partner to enjoy his company, and believes that his partner understands this. Sherlock enjoys talking about his partner and it is evident that he holds his partner in high esteem. 

Sherlock's partner, John, arrived ninety minutes into session and was invited to join us. 

I explained to Sherlock how to use the calm centred state as a theatre seat, and to let the memories flow like a movie on a screen, or as a series of still pictures. He was to allow the memories to run, nanosecond by nanosecond, observing from his calm state of just-being, then as each emotion, image and sensory sensation arose, catalogue them, colour code them by type, and draw them onto the paper as a flow chart, with the coloured markers. When emotions arose, he was to categorise them as discussed and colour-code them as emotions, but not to try to name them. He agreed to try this method. After several minutes, John asked if he could try the method as well, explaining that he had shared in the originating circumstances and shared similar nightmares with Sherlock, so it would be fitting for them to share healing together as well. 

John has an immensely grounding influence on Sherlock and shows considerable understanding of him. When Sherlock reached an ab-reaction crisis and could not regain his centred state, John was able to help him access it by drawing a cartoon of a skull, then, after some thought, adding some cross bones, explaining that Sherlock had liked pirates as a child. Immediately Sherlock returned to his centred state and was able to be present to the pain without being overwhelmed by it.

John related his own struggles with post-traumatic symptoms as a veteran of war and as a participant in the events that contributed to Sherlock's trauma. John considers Sherlock to be a healing influence in his life, views him as inspirational, and often feels hurt by the ostracism and verbal abuse that Sherlock still endures. John readily admits that he doesn't always understand his partner and that his mistakes have caused pain in the past. John is interested in understanding Sherlock and listened openly to my explanations of how people like Sherlock think, function, and communicate. He had several 'lightbulb moments' of sudden comprehension. John finds his own centre through responding to the needs of others and wishes to be as supportive to Sherlock as he feels Sherlock is to him. I gave John some reading material, including the workshop handouts, to help him understand Sherlock further. 

With John's support, Sherlock was able to process quite a lot of the originating traumatic event. They were even able to reach a state where they could have a laugh about their antagonist. Sherlock has agreed to continue sessions with me to process the trauma completely. A separate program will be prepared for John, who will also continue to be involved as support for Sherlock.


End file.
